Basic Information
| Provider Information | |||||||||
| NPI: | 1487818712 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DOWELL | ||||||||
| FirstName: | ROBERT | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 220 FORT SANDERS WEST BLVD | ||||||||
| Address2: | BLDG 2, SUITE 200 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37922 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8652884232 | ||||||||
| FaxNumber: | 8652884231 | ||||||||
| Practice Location | |||||||||
| Address1: | 220 FORT SANDERS WEST BLVD, BLDG 2 | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37992 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8652884232 | ||||||||
| FaxNumber: | 8652884232 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2008 | ||||||||
| LastUpdateDate: | 02/14/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 13552 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 103I500010 | 01 | MEDICARE | OTHER |